US20170347978A1 - Urology table with tiltable x-ray tube - Google Patents
Urology table with tiltable x-ray tube Download PDFInfo
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- US20170347978A1 US20170347978A1 US15/609,390 US201715609390A US2017347978A1 US 20170347978 A1 US20170347978 A1 US 20170347978A1 US 201715609390 A US201715609390 A US 201715609390A US 2017347978 A1 US2017347978 A1 US 2017347978A1
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Definitions
- the invention relates to a device including a urology table for Percutaneous Nephrolithotomy (PCNL) surgery of the human or animal body.
- a device includes a radiologic system, which allows to survey the surgery.
- Percutaneous Nephrolithotomy (PCNL) is the preferred technique for treating large stones (over 2 cm in diameter) in the kidney. It involves keyhole surgery performed through a small incision in the skin overlying the kidney. During the surgery, X-ray images are made in order to locate the position of the operating instruments in relation to the kidney stones.
- a commonality shared by the surgical systems in the field of urology is that the X-ray source and the X-ray detector have to be pivoted around the patient in a common orbit. This is necessary to make X-ray images of a subject in different orientations, for example to allow to survey a surgery and to detect the exact position(s) of operating instruments.
- the state of the art describes two different types of X-ray systems.
- the first type includes C-arm systems.
- the X-ray source is located at one end of a C-arm, and the X-ray detector is at the other side opposed to the X-ray source. Both may be rotated around a virtual center axis.
- the movement of the whole X-ray system is necessary in order to prevent image distortions and to allow pictures from different angles and positions.
- the surgeon and the operating room personal are limited in their freedom of movement by the C-arm of the X-ray system.
- the second type includes systems with a focus on ergonomic concentrated, fatigue-free work. These systems have an X-ray detector located in a position within or under the patient table.
- the X-ray source is located on a support, which is normally configured as an arm above the patient table and opposite to the X-ray detector.
- An electromechanical system in the surgery system allows pivoting and tilting the patient table into multiple positions in order to provide optimal working conditions for the doctor and his/her assistants, as well as a comfortable access position for the patient by changing the height of the table.
- the X-ray source and the X-ray detector are configured to be tilted synchronously, so that they are facing each other in every state or position.
- U.S. Pat. No. 7,942,575 B2 discloses a urological X-ray workstation with an X-ray source and an X-ray detector.
- the X-ray workstation as well as the X-ray source are supported on device retainers of a device carrier, which is located at the longitudinal side of a patient positioning table such that the X-ray source and the X-ray detector can be positioned opposite one another and independently from one another in various orientations on an orbit that proceeds around a common center in a working plane (the working plane is oriented orthogonally to the longitudinal axis of the patient positioning table).
- the disadvantage of this contraption stems from a complex, large, and heavy X-ray tube mount and a complex and expensive X-ray receiver positioning system.
- the embodiments of the inventions are aimed at the goal of providing an improved urological X-ray system and/or urology table with X-ray system, which allows an improved treatment procedure without the spatial restrictions of a mobile C-arm system and which simultaneously allows for an ergonomic concentrated, fatigue-free work.
- the disclosed X-ray system and/or urology table with X-ray system should has a simple and light-weight mechanical design, which consumes less space and offers the surgeon an expanded freedom of movement. Furthermore, manufacturing costs associated with the production of an embodiment of the invention are decreased in comparison with those of related art.
- a first embodiment relates to a urological radiology device.
- the device includes a patient table, an X-ray source and an X-ray detector. It may additionally include at least one X-ray source support configured to hold the device.
- a Cartesian coordinate system is defined.
- the point of origin of such Cartesian coordinate system preferably is arranged in the center of the upper surface of the patient table.
- X-axis and y-axis are in a plane defined by the patient table.
- the x-axis is parallel to a longitudinal side of the patient table.
- the y-axis is parallel to a broad side of the patient table.
- the longitudinal side is longer than the broad side.
- the z-axis points upwards and is orthogonal to the x-y plane.
- the X-ray source which preferably is an X-ray tube and which may include a high voltage power supply, is held above the patient table by an X-ray source support.
- the X-ray source support is preferably configured to allow movement of the X-ray source in a first plane parallel to and above the x-y plane with the use of at least one X-ray source linear drive. Most preferably, such linear drive is additionally configured to provide for a translational movement parallel to the y-axis, in y direction.
- the X-ray source may be aligned to emit an X-ray beam of X-ray radiation in the direction of a patient table and, when the patient is on the table, through the patient.
- the X-ray source may be appropriately equipped with a pivoting means (such as a rotatable shaft) to be pivotable around a first pivot axis.
- a pivoting means such as a rotatable shaft
- This configuration allows for keeping the X-ray beam aligned with respect to the patient (patient table) and/or the X-ray detector, even when the X-ray tube is being translated. Therefore, it is possible to orient the X-ray source to direct the X-ray beam from different angles and positions to the patient (patient table) at any time.
- the X-ray source preferably has an X-ray beam collimator.
- the X-ray radiation once emitted, can be detected with an X-ray detector unit, which preferably includes a planar detector within or under the patient table.
- the X-ray detector may be appropriately equipped with a repositioner to be moveable in a second plane that is parallel to the patient table.
- At least one X-ray detector linear drive is provided to move the X-ray detector and to align the X-ray detector with respect to the X-ray source to receive the emitted X-ray beam.
- the X-ray source and the X-ray detector may be moved such that a desired region or section of the patient positioned on the table is projected onto the detector. Most preferably, the same region of the patient on the patient table may be projected from different angles to the X-ray detector. Therefore, the X-ray source must be aligned with the X-ray detector in each position. This structural configuration allows taking X-ray images of the patient at different angles. Furthermore, it allows using a much simpler and cheaper mechanical mounting and bearing of the detector and the X-ray source.
- a control unit may be additionally provided.
- the control unit may be in practice connected to the X-ray source linear drive, the pivot mechanism, and the detector linear drive—preferably by at least one control cable.
- the control unit may be configured to coordinate the X-ray source linear drive, the pivot mechanism, and the detector linear drive as explained above. Alternatively, it may assert control signals, such that at least 50 percent of radiation contained in the X-ray beam be collected by the X-ray detector. In a situation when not all of the X-ray beam hits the detector, the beam's dimension has to be appropriately reduced by the collimator in such a way as to be fully received by the detector.
- the alignment of the X-ray source and the X-rays detector is carried out such that the center of the X-ray beam is aligned to the center of the X-ray detector and with a certain region of the patient to be imaged. It may be desirable to have a plurality of X-ray images of the same region from different directions.
- the X-ray dose may be adapted or varied depending on the mutual positioning of the X-ray source and the detector to ensure a constant level of X-ray energy at the detector.
- the adaptation may be appropriately coordinated to be made dependent on the patient characteristics.
- a keystone distortion present in images generated by the X-ray detector in a lateral state of the X-ray source, when the X-ray source is not directly above the X-ray detector but is laterally shifted in a plane parallel to the plane of the table. If present, such keystone distortion may be corrected digitally, with an image-processing unit (such as a programmable processor or computer).
- an image-processing unit such as a programmable processor or computer
- a basic unit may provide housing for a power supply, the image processing computer, a master control system, and mechanical systems configured to adjust position of at least one attachment part (such as, for example, the X-ray source support).
- a patient table may be attached to the basic unit via an X-ray source support.
- the patient table is designed to receive a patient thereon preferably in a treatment position.
- the patient table may be made of carbon composite, glass fiber composite material, or any other kind of X-ray transmissive material.
- the patient table may be positioned on an independent stand or foot.
- the device carrier and the patient table may be configured to be height-adjustable and pivotable around an axis of rotation to allow for an ergonomic positioning of the patient and for the surgeon, and to allow for easy handling of the patient during the surgery.
- the X-ray detector preferably is a flat panel detector.
- the detector may work based on GDO2 (Gadolinium dioxide) or CsJ (Cesiumjodide).
- GDO2 Gadolinium dioxide
- CsJ Cesiumjodide
- the X-ray image data generated by the X-ray detector is further transferred to an image-processing computer.
- the X-ray detector may be configured to be part of the patient table or may be part of a separate unit that is disposed below the patient table and that may be attached to the X-ray source support or to an extra stand or foot of the patient table.
- the patient table may be structured to be moveable, independently from the X-ray detector, in parallel to the x and/or y-axes.
- the X-ray source is supported by the X-ray source support, which may be a stand-alone, independent support standing at or attached to the ground.
- the X-ray source support comprises a first support section, a second support section, and a third support section.
- the second support section is attached orthogonally to a first support section in z-direction.
- the second support section may be attached to the patient table in z-direction.
- the third support section may be attached at one end to the second support section parallel to the first support section (y-direction).
- the third support section may be structured to be height adjustable in the direction of the z-axis.
- this section may be moveable by a linear moving means, in parallel to the y-axis.
- the other end of the third support section, holding the X-ray tube may be located above the patient table preferably opposite to the X-ray detector.
- the second and/or third support sections are moveable in a plane parallel to that of the patient table.
- Another embodiment of the invention relates to a method for recording a plurality of X-ray images of the target (such as same area of the patient's body) at or from different angles.
- the method includes at least one of the following steps:
- a multi-view image or a 3-D image may be generated from the first X-ray image and the second X-ray image and/or further X-ray images as a result of image data processing with a programmable processor.
- FIG. 1 shows a first embodiment of a urological device.
- FIG. 2 shows a related embodiment
- FIG. 3 shows the device with displaced and tilted X-ray tube.
- FIG. 4 shows the device from a top view.
- FIG. 5 shows a keystone distorted picture and a corrected one.
- FIG. 6 shows a block diagram of the movement control.
- FIG. 1 shows a first embodiment of a urological device.
- the device includes a patient table 110 , an X-ray source 120 , and an X-ray detector 130 .
- it may further include at least one X-ray source support 150 for holding the whole device, as well as a basic unit 140 configured to provide housing for a power supply, the image processing computer, a master control system and mechanical systems for adjusting the position of at least one attachment part for example the X-ray source support 150 .
- a Cartesian coordinate system is defined.
- the point of origin of the Cartesian coordinate system preferably is arranged in the center of the upper surface of the patient table.
- X-axis 410 and y-axis 420 are in a plane defined by the patient table.
- the x-axis 410 is parallel to a longitudinal side of the patient 110 table and the y-axis 420 is parallel to a broad side of the patient table.
- the z-axis 430 points upwards and is orthogonal to the x-y plane.
- the X-ray source 120 is held above the patient table 110 by an X-ray source support 150 and is translatable in a plane 441 parallel to the x-y plane and along the z-axis by an X-ray source linear drive 154 .
- the X-ray source 120 may be structured to be pivotable about a pivot axis 161 such as to align the X-ray source to emit an X-ray beam 121 in the direction of patient 200 on the patient table 110 .
- the X-ray source preferably has a collimator 122 for beam forming.
- An X-ray detector 130 within, or under, the patient table 110 is disposed to detect the X-ray radiation.
- the X-ray detector may be moveable in a second plane parallel to the x-y plane and the patient table 110 .
- At least one X-ray detector linear drive 155 allows for the X-ray detector 130 to be aligned with respect to the X-ray beam 121 and, preferably, with respect to the center of the X-ray beam.
- X-ray images from different angles of the same region of the patient 200 can be recorded (for example, to survey the surgery procedure).
- the patient table 110 may be attached to the basic unit 140 via an X-ray source support 150 (as shown—to a part 151 of the X-ray source support), which, in turn, may be attached to the basic unit 140 .
- the patient table 110 may be moveable independent from the X-ray detector 130 parallel to the x 410 and y-axis 420 .
- the X-ray source support 150 comprises a first support section 151 , a second support section 152 , and a third support section 153 .
- the second support section 152 is attached orthogonally to a first support section 151 , along the z-axis.
- the third support section 153 may be attached with one end to the second support section 152 , parallel to the first support section 151 (which extends in y-direction, 420 ).
- the third support section 153 may be configured to be height adjustable (in the direction of the z-axis 430 ). Preferably, it may be moveable by the X-ray source linear drive 154 parallel to the y-axis 420 .
- Another end of the third support section 153 holding the X-ray 120 tube, may be located above the patient table 200 preferably opposite to and above the X-ray detector 130 .
- the second 152 and/or third support 153 sections are configured to be moveable in a plane parallel to the plane of the patient table 200 .
- the X-ray detector preferably is a flat panel detector 130 .
- the detector may be based on GDO 2 (Gadolinium dioxide) or CsJ (Cesiumjodide).
- GDO 2 Gadolinium dioxide
- CsJ Cesiumjodide
- the X-ray image data generated by the X-ray detector 130 may be transferred to an image-processing computer (not shown).
- FIG. 2 shows a related embodiment.
- the X-ray source 120 and the X-ray detector 130 are shown moved in the same direction and by the same distance from the first centerline 165 .
- a desired region or section of the patient 200 that is different from the center of the patient 201 is projected to the X-ray detector 130 .
- the center line 166 representing the center/axis of the X-ray beam 122 does not run through the center 201 of the patient 200 .
- there is a lateral offset 168 between the first centerline 165 which runs through the center 201 of the patient 200 and the third centerline 166 .
- the X-ray source 120 and the X-ray detector 130 may be in a position facing each other. This movability/repositioning of the X-ray source 120 and the X-ray detector 130 allows to irradiate and image various parts of the patient 200 without the necessity of moving the patient 200 or changing the position of the patient table 110 .
- FIG. 3 shows the same urology device 100 as that of FIG. 1 , but with a laterally displaced and tilted X-ray tube.
- the X-ray source 120 is displaced parallel to the y-axis 420 with respect to the center 201 of the target (patient) 200 and therefore is laterally offset from the center 201 of the patient 200 .
- the X-ray source 120 is tilted around the first pivot axis 161 .
- the X-ray detector 130 has been moved in a direction opposite to the direction of displacement of the X-ray source 120 , and parallel to the y-axis 420 . By doing so, X-ray images of the center 201 of the patient 200 or of other target portions of the patient 200 may be procured from different perspectives or angles 164 . Therefore, multiple images can be composed into a 3-D image.
- the X-ray source 120 is moved in the first plane 441 parallel to the patient table 110 , while the X-ray detector 130 is moved in the second plane 442 parallel to the patient table 110 in an opposite direction.
- the distances of movement of the X-ray tube 120 and the X-ray detector 130 may be adjusted as required to preferably align the X-ray beam, emitted by the X-ray source, at the center of the X-ray detector 130 .
- the center of the X-ray beam 121 in a center position of the X-ray source 120 and the X-ray detector 130 is defined by a first centerline 165 .
- the center of the X-ray beam 121 is defined by a second centerline 167 .
- the angle 164 between the first centerline 165 and the second centerline 167 may be up to 40 degrees, and preferably 30 degrees.
- the patient table 110 may be moveable independently from the X-ray detector 130 in directions of the x-axis 410 and y-axis 420 .
- the patient 110 table may also be pivotable or rotatable about a second pivot axis 162 .
- a number of different images may be made from different angles 164 as shown above in FIG. 3 by moving the X-ray source 120 and the X-ray detector 130 in opposite directions.
- FIG. 4 presents a top view of the urology device 100 from FIG. 1 .
- the urology device 100 comprises a patient table 110 , a basic unit 140 , an X-ray source 120 and an X-ray detector 130 .
- FIG. 5 presents two illustrations 300 , 301 .
- the first illustration 300 depicts an image of a scene in a state where the X-ray source 120 and the X-ray detector 130 are facing each other. In this state, there is no keystone distortion.
- the other operational state of the device (which corresponds to, for example, FIG. 3 ) there is a keystone distortion of the X-ray image of the scene, as shown.
- the keystone distortion has to be corrected by digital post processing.
- FIG. 6 illustrates a control unit 500 for the at least two linear movement mechanisms 154 , 155 of the X-ray source 154 and the X-ray detector 155 , and the pivot mechanism 156 of the X-ray source 120 .
- the control unit may be connected to the X-ray source linear drive 154 , the pivot mechanism 156 , and the detector linear drive 154 preferably by at least one control cable 510 .
- the control unit 500 may be configured to coordinate the operation(s) of the X-ray source linear drive 154 , the pivot mechanism 156 , and the detector linear drive 155 as explained above.
- the X-ray beam is aligned to, or preferably centered on the X-ray detector.
- control unit 500 it may provide control signals, such that the X-ray detector may collect at least 50 percent of the X-ray beam. Nevertheless, if not the complete X-ray beam hits the detector is has be reduced in size by the collimator in such a way, that now x-ray can pass next the detector.
- an external control 520 can be connected to the control unit 500 .
- the external control can be a manual control and/or a master computer.
- the control unit 500 may be part of the basic unit 140 or the master computer.
- the communication between the different parts can be a unidirectional communication or bidirectional communication.
Abstract
Description
- This application claims priority from pending European Application No. 16173033.8, filed on Jun. 6, 2016. The disclosure of the priority application is incorporated by reference herein in its entirety.
- The invention relates to a device including a urology table for Percutaneous Nephrolithotomy (PCNL) surgery of the human or animal body. Such a device includes a radiologic system, which allows to survey the surgery. Percutaneous Nephrolithotomy (PCNL) is the preferred technique for treating large stones (over 2 cm in diameter) in the kidney. It involves keyhole surgery performed through a small incision in the skin overlying the kidney. During the surgery, X-ray images are made in order to locate the position of the operating instruments in relation to the kidney stones.
- A commonality shared by the surgical systems in the field of urology is that the X-ray source and the X-ray detector have to be pivoted around the patient in a common orbit. This is necessary to make X-ray images of a subject in different orientations, for example to allow to survey a surgery and to detect the exact position(s) of operating instruments.
- The state of the art describes two different types of X-ray systems. The first type includes C-arm systems. Here, the X-ray source is located at one end of a C-arm, and the X-ray detector is at the other side opposed to the X-ray source. Both may be rotated around a virtual center axis. The movement of the whole X-ray system is necessary in order to prevent image distortions and to allow pictures from different angles and positions. The surgeon and the operating room personal are limited in their freedom of movement by the C-arm of the X-ray system.
- The second type includes systems with a focus on ergonomic concentrated, fatigue-free work. These systems have an X-ray detector located in a position within or under the patient table. The X-ray source is located on a support, which is normally configured as an arm above the patient table and opposite to the X-ray detector. An electromechanical system in the surgery system allows pivoting and tilting the patient table into multiple positions in order to provide optimal working conditions for the doctor and his/her assistants, as well as a comfortable access position for the patient by changing the height of the table. The X-ray source and the X-ray detector are configured to be tilted synchronously, so that they are facing each other in every state or position.
- U.S. Pat. No. 7,942,575 B2 discloses a urological X-ray workstation with an X-ray source and an X-ray detector. The X-ray workstation as well as the X-ray source are supported on device retainers of a device carrier, which is located at the longitudinal side of a patient positioning table such that the X-ray source and the X-ray detector can be positioned opposite one another and independently from one another in various orientations on an orbit that proceeds around a common center in a working plane (the working plane is oriented orthogonally to the longitudinal axis of the patient positioning table). The disadvantage of this contraption stems from a complex, large, and heavy X-ray tube mount and a complex and expensive X-ray receiver positioning system.
- The embodiments of the inventions are aimed at the goal of providing an improved urological X-ray system and/or urology table with X-ray system, which allows an improved treatment procedure without the spatial restrictions of a mobile C-arm system and which simultaneously allows for an ergonomic concentrated, fatigue-free work. The disclosed X-ray system and/or urology table with X-ray system should has a simple and light-weight mechanical design, which consumes less space and offers the surgeon an expanded freedom of movement. Furthermore, manufacturing costs associated with the production of an embodiment of the invention are decreased in comparison with those of related art.
- A first embodiment relates to a urological radiology device. The device includes a patient table, an X-ray source and an X-ray detector. It may additionally include at least one X-ray source support configured to hold the device.
- For easier reference in the following description, a Cartesian coordinate system is defined. The point of origin of such Cartesian coordinate system preferably is arranged in the center of the upper surface of the patient table. X-axis and y-axis are in a plane defined by the patient table. The x-axis is parallel to a longitudinal side of the patient table. The y-axis is parallel to a broad side of the patient table. The longitudinal side is longer than the broad side. The z-axis points upwards and is orthogonal to the x-y plane.
- The X-ray source, which preferably is an X-ray tube and which may include a high voltage power supply, is held above the patient table by an X-ray source support. The X-ray source support is preferably configured to allow movement of the X-ray source in a first plane parallel to and above the x-y plane with the use of at least one X-ray source linear drive. Most preferably, such linear drive is additionally configured to provide for a translational movement parallel to the y-axis, in y direction.
- The X-ray source may be aligned to emit an X-ray beam of X-ray radiation in the direction of a patient table and, when the patient is on the table, through the patient. For improved alignment, the X-ray source may be appropriately equipped with a pivoting means (such as a rotatable shaft) to be pivotable around a first pivot axis. This configuration allows for keeping the X-ray beam aligned with respect to the patient (patient table) and/or the X-ray detector, even when the X-ray tube is being translated. Therefore, it is possible to orient the X-ray source to direct the X-ray beam from different angles and positions to the patient (patient table) at any time. The X-ray source preferably has an X-ray beam collimator.
- The X-ray radiation, once emitted, can be detected with an X-ray detector unit, which preferably includes a planar detector within or under the patient table. The X-ray detector may be appropriately equipped with a repositioner to be moveable in a second plane that is parallel to the patient table. At least one X-ray detector linear drive is provided to move the X-ray detector and to align the X-ray detector with respect to the X-ray source to receive the emitted X-ray beam.
- Alternatively, the X-ray source and the X-ray detector may be moved such that a desired region or section of the patient positioned on the table is projected onto the detector. Most preferably, the same region of the patient on the patient table may be projected from different angles to the X-ray detector. Therefore, the X-ray source must be aligned with the X-ray detector in each position. This structural configuration allows taking X-ray images of the patient at different angles. Furthermore, it allows using a much simpler and cheaper mechanical mounting and bearing of the detector and the X-ray source.
- To coordinate the movement of at least two linear movement mechanisms of the X-ray source and the X-ray detector and the pivot mechanism of the X-ray source, a control unit may be additionally provided. The control unit may be in practice connected to the X-ray source linear drive, the pivot mechanism, and the detector linear drive—preferably by at least one control cable. The control unit may be configured to coordinate the X-ray source linear drive, the pivot mechanism, and the detector linear drive as explained above. Alternatively, it may assert control signals, such that at least 50 percent of radiation contained in the X-ray beam be collected by the X-ray detector. In a situation when not all of the X-ray beam hits the detector, the beam's dimension has to be appropriately reduced by the collimator in such a way as to be fully received by the detector.
- Preferably, the alignment of the X-ray source and the X-rays detector is carried out such that the center of the X-ray beam is aligned to the center of the X-ray detector and with a certain region of the patient to be imaged. It may be desirable to have a plurality of X-ray images of the same region from different directions.
- There may be further included a means for adaptation or change of an X-ray dose, to compensate for variation of the distance between the X-ray source and the X-ray detector with position. Therefore, in one implementation, the X-ray dose may be adapted or varied depending on the mutual positioning of the X-ray source and the detector to ensure a constant level of X-ray energy at the detector. Furthermore, the adaptation may be appropriately coordinated to be made dependent on the patient characteristics.
- As the X-ray detector is not tilted, there may be a keystone distortion present in images generated by the X-ray detector in a lateral state of the X-ray source, when the X-ray source is not directly above the X-ray detector but is laterally shifted in a plane parallel to the plane of the table. If present, such keystone distortion may be corrected digitally, with an image-processing unit (such as a programmable processor or computer).
- A basic unit may provide housing for a power supply, the image processing computer, a master control system, and mechanical systems configured to adjust position of at least one attachment part (such as, for example, the X-ray source support).
- A patient table may be attached to the basic unit via an X-ray source support. In one implementation, the patient table is designed to receive a patient thereon preferably in a treatment position. The patient table may be made of carbon composite, glass fiber composite material, or any other kind of X-ray transmissive material. In a related embodiment, the patient table may be positioned on an independent stand or foot. The device carrier and the patient table may be configured to be height-adjustable and pivotable around an axis of rotation to allow for an ergonomic positioning of the patient and for the surgeon, and to allow for easy handling of the patient during the surgery.
- The X-ray detector preferably is a flat panel detector. The detector may work based on GDO2 (Gadolinium dioxide) or CsJ (Cesiumjodide). The X-ray image data generated by the X-ray detector is further transferred to an image-processing computer. The X-ray detector may be configured to be part of the patient table or may be part of a separate unit that is disposed below the patient table and that may be attached to the X-ray source support or to an extra stand or foot of the patient table. The patient table may be structured to be moveable, independently from the X-ray detector, in parallel to the x and/or y-axes.
- In one case, the X-ray source is supported by the X-ray source support, which may be a stand-alone, independent support standing at or attached to the ground. In a preferred embodiment, the X-ray source support comprises a first support section, a second support section, and a third support section. Preferably, the second support section is attached orthogonally to a first support section in z-direction. Alternatively, the second support section may be attached to the patient table in z-direction. The third support section may be attached at one end to the second support section parallel to the first support section (y-direction). The third support section may be structured to be height adjustable in the direction of the z-axis. Preferably, this section may be moveable by a linear moving means, in parallel to the y-axis. The other end of the third support section, holding the X-ray tube may be located above the patient table preferably opposite to the X-ray detector. Most preferably, the second and/or third support sections are moveable in a plane parallel to that of the patient table.
- Another embodiment of the invention relates to a method for recording a plurality of X-ray images of the target (such as same area of the patient's body) at or from different angles. The method includes at least one of the following steps:
-
- Positioning an X-ray source in a first position above a patient table to face an X-ray detector that is disposed within or under the patient table (such that, in operation, the X-ray source emits the X-rays towards or in the direction of the X-ray detector).
- Generating an X-ray beam with the X-ray source and generating a first X-ray image of a section of a target (for example, a patient) on the patient table with the X-ray detector.
- Moving/displacing the X-ray source parallel to a y-axis (that is preferably in a plane of the patient table and parallel to a broad side of the patient table) with an X-ray source linear drive to a second position and pivoting the X-ray source with a pivoting means to align the X-ray beam with the contours or bounds of the target (the patient body).
- Moving the X-ray detector parallel to the y-axis in a direction opposite to the direction of displacement of the X-ray source to align the X-ray detector with the X-ray beam.
- Generating another X-ray beam with the X-ray source and generating a second X-ray image of a section of a patient on the patient table (and, in a specific case, the second image of the same section) with the X-ray detector.
- Furthermore, a multi-view image or a 3-D image may be generated from the first X-ray image and the second X-ray image and/or further X-ray images as a result of image data processing with a programmable processor.
- In the following, the invention will be described by way of example, without limitation of the general inventive concept, on examples of embodiment and with reference to the drawings.
-
FIG. 1 shows a first embodiment of a urological device. -
FIG. 2 shows a related embodiment. -
FIG. 3 shows the device with displaced and tilted X-ray tube. -
FIG. 4 shows the device from a top view. -
FIG. 5 shows a keystone distorted picture and a corrected one. -
FIG. 6 shows a block diagram of the movement control. - While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof are shown by way of example in the drawings and will herein be described in detail. It should be understood, however, that the drawings and detailed description thereto are not intended to limit the invention to the particular form disclosed, but on the contrary, the intention is to cover all modifications, equivalents and alternatives falling within the spirit and scope of the present invention as defined by the appended claims.
-
FIG. 1 shows a first embodiment of a urological device. The device includes a patient table 110, anX-ray source 120, and anX-ray detector 130. In a preferred embodiment, it may further include at least oneX-ray source support 150 for holding the whole device, as well as abasic unit 140 configured to provide housing for a power supply, the image processing computer, a master control system and mechanical systems for adjusting the position of at least one attachment part for example theX-ray source support 150. - For easier reference of the following, a Cartesian coordinate system is defined. The point of origin of the Cartesian coordinate system preferably is arranged in the center of the upper surface of the patient table. (For a better clarity of the drawings, the axes of the coordinate system in the drawings is shown below the patient table.)
X-axis 410 and y-axis 420 are in a plane defined by the patient table. Thex-axis 410 is parallel to a longitudinal side of thepatient 110 table and the y-axis 420 is parallel to a broad side of the patient table. The z-axis 430 points upwards and is orthogonal to the x-y plane. - The
X-ray source 120 is held above the patient table 110 by anX-ray source support 150 and is translatable in aplane 441 parallel to the x-y plane and along the z-axis by an X-ray sourcelinear drive 154. - Additionally the
X-ray source 120 may be structured to be pivotable about apivot axis 161 such as to align the X-ray source to emit anX-ray beam 121 in the direction ofpatient 200 on the patient table 110. The X-ray source preferably has acollimator 122 for beam forming. - An
X-ray detector 130 within, or under, the patient table 110 is disposed to detect the X-ray radiation. The X-ray detector may be moveable in a second plane parallel to the x-y plane and the patient table 110. At least one X-ray detectorlinear drive 155 allows for theX-ray detector 130 to be aligned with respect to theX-ray beam 121 and, preferably, with respect to the center of the X-ray beam. Thus, X-ray images from different angles of the same region of thepatient 200 can be recorded (for example, to survey the surgery procedure). - The patient table 110 may be attached to the
basic unit 140 via an X-ray source support 150 (as shown—to apart 151 of the X-ray source support), which, in turn, may be attached to thebasic unit 140. The patient table 110 may be moveable independent from theX-ray detector 130 parallel to the x 410 and y-axis 420. TheX-ray source support 150 comprises afirst support section 151, asecond support section 152, and athird support section 153. Thesecond support section 152 is attached orthogonally to afirst support section 151, along the z-axis. Thethird support section 153 may be attached with one end to thesecond support section 152, parallel to the first support section 151 (which extends in y-direction, 420). Thethird support section 153 may be configured to be height adjustable (in the direction of the z-axis 430). Preferably, it may be moveable by the X-ray sourcelinear drive 154 parallel to the y-axis 420. Another end of thethird support section 153, holding theX-ray 120 tube, may be located above the patient table 200 preferably opposite to and above theX-ray detector 130. Most preferably, the second 152 and/orthird support 153 sections are configured to be moveable in a plane parallel to the plane of the patient table 200. - The X-ray detector preferably is a
flat panel detector 130. The detector may be based on GDO2 (Gadolinium dioxide) or CsJ (Cesiumjodide). The X-ray image data generated by theX-ray detector 130 may be transferred to an image-processing computer (not shown). -
FIG. 2 shows a related embodiment. Here, theX-ray source 120 and theX-ray detector 130 are shown moved in the same direction and by the same distance from thefirst centerline 165. As a result, a desired region or section of thepatient 200 that is different from the center of thepatient 201, is projected to theX-ray detector 130. Therefore, as shown, thecenter line 166 representing the center/axis of theX-ray beam 122, does not run through thecenter 201 of thepatient 200. Instead, there is a lateral offset 168 between thefirst centerline 165, which runs through thecenter 201 of thepatient 200 and thethird centerline 166. As shown, theX-ray source 120 and theX-ray detector 130 may be in a position facing each other. This movability/repositioning of theX-ray source 120 and theX-ray detector 130 allows to irradiate and image various parts of thepatient 200 without the necessity of moving thepatient 200 or changing the position of the patient table 110. -
FIG. 3 shows thesame urology device 100 as that ofFIG. 1 , but with a laterally displaced and tilted X-ray tube. TheX-ray source 120 is displaced parallel to the y-axis 420 with respect to thecenter 201 of the target (patient) 200 and therefore is laterally offset from thecenter 201 of thepatient 200. TheX-ray source 120 is tilted around thefirst pivot axis 161. - The
X-ray detector 130 has been moved in a direction opposite to the direction of displacement of theX-ray source 120, and parallel to the y-axis 420. By doing so, X-ray images of thecenter 201 of thepatient 200 or of other target portions of thepatient 200 may be procured from different perspectives or angles 164. Therefore, multiple images can be composed into a 3-D image. - To obtain a good alignment of the
X-ray source 120 and theX-ray detector 130, preferably theX-ray source 120 is moved in thefirst plane 441 parallel to the patient table 110, while theX-ray detector 130 is moved in thesecond plane 442 parallel to the patient table 110 in an opposite direction. The distances of movement of theX-ray tube 120 and theX-ray detector 130 may be adjusted as required to preferably align the X-ray beam, emitted by the X-ray source, at the center of theX-ray detector 130. - The center of the
X-ray beam 121 in a center position of theX-ray source 120 and theX-ray detector 130 is defined by afirst centerline 165. In a lateral position of the X-ray source, the center of theX-ray beam 121 is defined by asecond centerline 167. Theangle 164 between thefirst centerline 165 and thesecond centerline 167 may be up to 40 degrees, and preferably 30 degrees. The patient table 110 may be moveable independently from theX-ray detector 130 in directions of thex-axis 410 and y-axis 420. Thepatient 110 table may also be pivotable or rotatable about asecond pivot axis 162. - In addition, a number of different images may be made from
different angles 164 as shown above inFIG. 3 by moving theX-ray source 120 and theX-ray detector 130 in opposite directions. -
FIG. 4 presents a top view of theurology device 100 fromFIG. 1 . Theurology device 100 comprises a patient table 110, abasic unit 140, anX-ray source 120 and anX-ray detector 130. -
FIG. 5 presents twoillustrations first illustration 300 depicts an image of a scene in a state where theX-ray source 120 and theX-ray detector 130 are facing each other. In this state, there is no keystone distortion. In the other operational state of the device (which corresponds to, for example,FIG. 3 ) there is a keystone distortion of the X-ray image of the scene, as shown. The keystone distortion has to be corrected by digital post processing. -
FIG. 6 illustrates acontrol unit 500 for the at least twolinear movement mechanisms X-ray source 154 and theX-ray detector 155, and thepivot mechanism 156 of theX-ray source 120. The control unit may be connected to the X-ray sourcelinear drive 154, thepivot mechanism 156, and the detectorlinear drive 154 preferably by at least onecontrol cable 510. Thecontrol unit 500 may be configured to coordinate the operation(s) of the X-ray sourcelinear drive 154, thepivot mechanism 156, and the detectorlinear drive 155 as explained above. Preferably, the X-ray beam is aligned to, or preferably centered on the X-ray detector. Alternatively, it may provide control signals, such that the X-ray detector may collect at least 50 percent of the X-ray beam. Nevertheless, if not the complete X-ray beam hits the detector is has be reduced in size by the collimator in such a way, that now x-ray can pass next the detector. Additionally anexternal control 520 can be connected to thecontrol unit 500. The external control can be a manual control and/or a master computer. Thecontrol unit 500 may be part of thebasic unit 140 or the master computer. The communication between the different parts can be a unidirectional communication or bidirectional communication. - It will be appreciated to those skilled in the art having the benefit of this disclosure that this invention is believed to provide a device including a urology table for Percutaneous Nephrolithotomy (PCNL) surgery. Modifications and alternative embodiments of various aspects of the invention can be made without deviation from the scope of the invention. Accordingly, this description is to be construed as illustrative only and is for the purpose of teaching those skilled in the art the general manner of carrying out the invention. It is to be understood that the forms of the invention shown and described herein are to be taken as the presently preferred embodiments. Elements and materials may be substituted for those illustrated and described herein, parts and processes may be reversed, and certain features of the invention may be utilized independently, all as would be apparent to one skilled in the art after having the benefit of this description of the invention. Changes may be made in the elements described herein without departing from the spirit and scope of the invention as described in the following claims.
-
- 100 Urology device
- 110 Patient table
- 120 X-ray source
- 121 X-ray beam
- 122 Collimator
- 130 X-ray detector
- 140 Basic unit
- 150 X-ray source support
- 151 First support section
- 152 Second support section
- 153 Third support section
- 154 X-ray source linear drive
- 155 X-ray detector linear drive
- 156 Pivot mechanism
- 161 First pivot axis
- 162 Second pivot axis
- 164 Interior angle
- 165 First centerline
- 166 Third centerline
- 167 Second centerline
- 168 Offset
- 200 Patient
- 201 Center
- 300 Image
- 301 Image with keystone distortion
- 410 x-axis, direction
- 420 Y-axis, direction
- 430 z-axis, direction
- 441 First plane (X-ray tube)
- 442 Second plane (X-ray detector)
- 500 Control unit
- 510 Control cable
- 520 External control
Claims (13)
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EP16173033.8 | 2016-06-06 | ||
EP16173033.8A EP3254626A1 (en) | 2016-06-06 | 2016-06-06 | Urology table with tiltable x-ray tube |
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US20170347978A1 true US20170347978A1 (en) | 2017-12-07 |
US10478135B2 US10478135B2 (en) | 2019-11-19 |
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US15/609,390 Expired - Fee Related US10478135B2 (en) | 2016-06-06 | 2017-05-31 | Urology table with tiltable X-ray tube |
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